Lifelines: Of Honeysuckle and Sepsis
| August 3, 2016This is strange, I thought. Maybe I should take him to the doctor now.
Photo: Shutterstock
It was the day of the Big Pesach Shopping. I was standing in my kitchen unloading bags upon bags of potato starch sugar oil onions and various other Pesach staples. Earlier that day I had taken 11-month-old Eliyahu who was sick with me to the supermarket and I had stocked up on all the non-perishables we would need for Yom Tov which was ten days away.
I had already cleaned out the cabinets and pantry to make room for the Pesach items, but the counters and table were not yet Pesachdig, so when I came home from the supermarket, I lined those surfaces with garbage bags so that I could unpack the groceries onto them.
Eliyahu was still sitting in his stroller, lethargic from the fever that he’d had for the past three days. I wasn’t particularly concerned, because Eliyahu was the type of baby who came down with fever every few weeks; he’d been on antibiotics close to a dozen times in his young life, mostly for ear infections. Pesach cleaning notwithstanding, I knew that after three days of fever, taking him to the doctor was the responsible thing to do. So that morning, I had called the local clinic and made an appointment for five p.m.
At 2:30 in the afternoon, as I was unpacking the bags, I noticed that Eliyahu looked weird. His limbs kept jerking involuntarily — first his arm flailed to the side, then his head bobbed up and down, then his knee jumped.
This is strange, I thought. Maybe I should take him to the doctor now.
Our pediatrician, Dr. Kleinfeld, was a real stickler for time. He wouldn’t see patients who came late, nor would he see them before the time of their appointment. There’s no point in taking Eliyahu to the clinic now, I told myself. Dr. Kleinfeld will never let him in.
But Eliyahu really didn’t look good. His lips were blue, his skin was pale and greyish, and he seemed apathetic. I have to do what’s right for him, I decided. Even if it means that I’ll feel like a fool when I get to the clinic and they tell me to wait until five.
I took one last look at my hurricane of a kitchen. By the time I’d get home from the clinic, the older kids would be home, and who knew what kind of mess I’d have to deal with then. I shook my head, wondering why I was going out to the doctor now instead of just waiting two hours until my appointment.
When I walked into the clinic, Dr. Kleinfeld was seeing a patient. Curiously, however, there was no one in the waiting room, even though the clinic was usually teeming with patients. Even more curiously, when the door opened and the patient exited, Dr. Kleinfeld motioned to me to enter, and didn’t say a word about the fact that my appointment was not for another two hours.
“Undress the baby,” he instructed me, while typing something into his computer. “I’ll be with you in a minute.”
As I finished undressing Eliyahu, Dr. Kleinfeld looked up and saw his greyish body and bluish hands, feet, and lips. He stood up abruptly. “Get your baby to the nurse this second, and tell her to take his vital signs and start an IV.”
I pushed Eliyahu in his stroller over to the nurse’s room. “Dr. Kleinfeld asked if you could take his vital signs and start an IV,” I said matter of factly.
“Sure,” she replied. “I’m just in middle of dealing with an ingrown toenail, so I’ll be with you in a couple of minutes.”
The next thing I knew, Dr. Kleinfeld came charging into the nurse’s room. “This is urgent!” he declared. He grabbed an IV needle from a drawer and jabbed it straight into Eliyahu’s jugular vein. In the meantime, the nurse had started taking Eliyahu’s vital signs. Dr. Kleinfeld frowned when he saw the results.
“I need you to run to the pharmacy and get some IV antibiotic,” he instructed the nurse.
Watching her dash out of the office to get the antibiotic, I felt bad for the kid whose ingrown toenail treatment had been so rudely aborted. By this time, the waiting room had filled up with other patients, and I felt uncomfortable, knowing that they were all waiting because of me.
When the nurse returned, Dr. Kleinfeld connected the bag of antibiotic to Eliyahu’s IV, and then turned around and told the nurse to call an ambulance. “Not a regular ambulance,” he added. “A mobile ICU. Tell them we have an 11-month-old baby with septic shock.”
“Eliyahu has septic shock?” I asked in confusion. Wasn’t that something that happened to old people in the hospital?
“I’m not really sure,” Dr. Kleinfeld said. “But it will get them to come faster.”
I smiled, feeling relieved. Dr. Kleinfeld really knew how to play the system. He didn’t want me to have to wait too long, especially considering that it was right before Pesach. Had Eliyahu’s condition been serious, he would certainly have told me. I remembered that when my older daughter had been experiencing severe headaches and vomiting, he had dispatched us to the emergency room and told us that he wanted to rule out a brain tumor. No, he wasn’t the type of doctor who tried to cushion parents.
“Believe it or not,” he said to me, “I actually just downloaded today an app with the contact information of all the doctors in the hospital. So now I have the number of the doctor on call in the emergency room. I’m going to call ahead and let him know you’re coming.”
That was really nice of him. At least we’d be in and out of the hospital quickly.
I called my husband, Yaakov, and told him that Dr. Kleinfeld was sending us to the hospital. “Can you bring me some diapers and a bottle?” I asked. “There might be a long wait in the emergency room. And I left a huge mess in the kitchen, I’m so sorry.”
When the ambulance arrived, I stepped inside calmly, and as the ambulance whizzed to the closest hospital, I sat and played with Eliyahu, who had regained his color after receiving the IV fluids. The ride reminded me of the only other time I had been in an ambulance, which had been after Yaakov fainted unexpectedly and collapsed, hitting his head on the floor. During that ambulance ride, I had been beside myself with panic, wondering if my husband was going to die. But this time, I wasn’t worried at all.
When we reached the emergency room, a crew of about ten doctors converged on us and whisked Eliyahu off.
Wow, I thought. We’re really getting VIP service. I had been to the emergency room several times before with my other children, and no one had ever been waiting to greet us.
Within minutes, the doctors had hooked Eliyahu up to oxygen and attached to his little body every kind of tube you could think of. Eliyahu was being a sport about the whole thing, crying only a little when they did the spinal tap, and not putting up much resistance.
While all this was going on, I was making phone calls to my neighbors, trying to arrange for someone to bring my older son home from school. “I’m in the emergency room right now with Eliyahu,” I explained.
“Oh no!” they exclaimed. “Should we daven for him?”
“No, he’s totally fine,” I assured them. “The doctors just want to be on the safe side, that’s all.”
At one point, one of the doctors passed by, and I asked him, “Am I going to be here overnight?”
He looked at me as though I had fallen from the moon. Then he gave a little smile and nodded.
Argh, I thought. That’s so annoying. I hate sleeping in the hospital. And I have so much to do at home!
Later, a nurse came to inform me that they were transferring Eliyahu to a unit. That’s weird, I thought. She put Eliyahu’s file down, and I noticed a paper on top of the file with instructions to move him to the ICU. “We’re going to intensive care?” I asked in surprise.
“Yes,” she said, eyeing me strangely.
When the orderly arrived to move Eliyahu to the ICU, he informed me that we had to wait for a doctor to accompany us. Yet another strange development. Why couldn’t we just walk over to the ICU ourselves?
At this point, it started to dawn on me that the medical staff was taking Eliyahu’s condition very seriously. When I opened Eliyahu’s file, I saw one big word: SEPSIS. Still, I didn’t feel very concerned.
When we were settled in the ICU, I called my mother, who’s generally very level-headed when it comes to medical issues. “Everything’s fine, Ma,” I said, “but Eliyahu is in the ICU with septic shock.”
“Oh, my,” she said in alarm. Then, she quickly switched to a soothing tone, as though she didn’t want to make me agitated. “Everything will be okay,” she assured me. “Just put one foot in front of the other. We’ll daven a lot for Eliyahu.”
Why was she overreacting? It was so not like her to be neurotic.
I spent an uncomfortable night in the ICU, hoping that in the morning this would all be over and we could go back home. By the morning, Eliyahu was back to his usual perky self, crawling all over the ICU and playing peekaboo with the nurses.
“You don’t belong here,” one of them said.
Duh, I thought. Finally, they were coming to their senses.
When I heard a doctor say something about transferring Eliyahu, I thought he meant that he’d go home. Turned out, they actually transferred him to the children’s ward. “He needs to be here for another day,” they told me. “He’s out of danger, but we’re still trying to figure out what caused the septic shock.”
Later that day, Dr. Kleinfeld came to visit us, which was way beyond the call of duty. He sat down with me and explained what had happened to Eliyahu.
“Septic shock happens when the body shuts down in response to an infection,” he said. “First, the extremities shut down, as the body focuses on preserving the vital organs, but after that, the entire body shuts down. And it doesn’t take very long. Had you come in at five o’clock, it would have been too late.”
“I’m not even sure why I rushed over to the clinic,” I told him. “It wasn’t as if I felt this urgent maternal instinct that something was wrong and I had to get him medical attention. I actually thought coming in early was a dumb thing to do.”
“So why did you come in?” he asked.
“Because Eliyahu looked weird.”
“That was the maternal instinct,” he replied. “The fact that you came in against your better judgment.”
I told the doctor that the reason I had decided to bring Eliyahu to the clinic early was that his limbs were jerking. “Those are signs of a febrile seizure,” Dr. Kleinfeld said. “But septic shock does not cause febrile seizures. How peculiar.”
Dr. Kleinfeld also told me that he had been certain, as soon as he saw the vital signs, that Eliyahu was suffering from septic shock. Why he had told me when ordering the ambulance that he was just invoking the possibility of septic shock to make the ambulance come faster, remained a mystery. But the fact was that those few words led me to believe that it wasn’t a true emergency, which allowed me to remain totally calm and composed throughout the ordeal.
After Dr. Kleinfeld left, I sat silently and absorbed his version of the events — which was completely different from the way I experienced them. When I walked into his clinic, I saw a child who needed medical attention; he saw a child who was about to die.
At that moment, the emotions of the past 24 hours came crashing down on me, as I recognized how close we had come to losing Eliyahu.
I needed to get out of the hospital to deal with this emotional avalanche, so I got permission from the medical staff to take Eliyahu outside in his stroller for a walk. We passed by some coffee shops, where people were sitting outside, eating, chatting, and drinking coffee. To me, it felt surreal. Here I was, on a brief furlough from the hospital, while there were people alive who could blithely sip coffee.
It occurred to me, then, that the people who were seeing me strolling down the boulevard with my baby might assume that I was equally carefree; how would they know that Eliyahu was gravely ill? Just as they could not imagine that I was going through a crisis, I had no idea what was actually going on in their lives. Which made the picture I was seeing even more complex and bewildering. How could I be inhabiting the same world as all these people, with their wildly divergent lives?
I couldn’t even make sense of my own life anymore. Yesterday, I had been consumed with shopping and cleaning for Pesach. Now, Pesach preparations were the last thing on my mind. All I could think about was Eliyahu’s narrow brush with death — and how oblivious I had been to the danger. At home, Yaakov was dealing with the after-school meltdowns, helping with homework, maybe throwing in a load of laundry. I, on the other hand, had been thrust into an unfamiliar orbit of white coats and beeping monitors and snaking IV lines. This couldn’t all be happening in the same world, right?
As I was pondering this existential dilemma, I smelled a familiar and delightful scent: the scent of honeysuckle. Honeysuckle has always been my favorite fragrance, and whenever I come across it, it fills me with tranquility. As I inhaled the heady scent, I was reminded of Yosef Hatzaddik smelling the fragrant spices during his descent to Egypt.
Ah, I thought. So Hashem is telling me that He’s right here with me. He created this life-threatening crisis, and He also created the honeysuckle to inject tranquility in the midst of the crisis. Eliyahu is in His hands, I’m in His hands, and all the people I’m seeing are in His hands, too. Every bit of this is calculated, down to the scent I’m inhaling.
I returned to the hospital strangely serene, yet finally attuned to the seriousness of my baby’s condition.
By this time, the hospital staff had run all sorts of blood tests on Eliyahu, trying to determine what the cause of the infection was so that they could treat it correctly. But because Dr. Kleinfeld had administered IV antibiotics in the clinic — saving Eliyahu’s life in the process — the blood test results were skewed, and the doctors never did figure out what the underlying infection had been.
After another full day in the hospital, the doctors told me that Eliyahu would have to stay in the hospital for another 48 hours. The next day they said 72 hours. After that they said they wanted to keep him for a week. All this time, they continued to pump his little body with IV antibiotics, just to be on the safe side.
We returned home from the hospital three days before Pesach. Our Pesach cleaning was a strictly halachic one, with no extras. It was only when Yom Tov began, and the pre-Pesach whirlwind was over, that Yaakov and I were able to really process what had happened.
Then, the “what ifs” started. What if I hadn’t decided to take Eliyahu to the clinic early? What if Dr. Kleinfeld hadn’t seen us immediately? What if he would have abided by the clinic protocol and not given Eliyahu the IV antibiotics on the spot?
That wasn’t all. What if Eliyahu had gone into septic shock while he was sleeping? What if he had been with a babysitter? What if — what if we would have come to the Seder with no Eliyahu?
After chewing it over for a few days, Yaakov and I concluded that all the what ifs were irrelevant. Dr. Kleinfeld, wonderful shaliach that he was, was just that — a shaliach. He rose to the occasion because that’s what Hashem wanted. We were eternally grateful to him, but he was not the true Hero of the situation.
To me, the strangest part of the ordeal was that I did not feel any fear or anxiety when Eliyahu was fighting for his life. I simply did not recognize the gravity of the situation — until the danger had passed.
This was extremely out of character for me, because I’m a very pragmatic, down-to-earth person, not the type who’s given to delusions or denial. Why, in this case, was I so calm, given the reality of the situation?
The only possible answer was that Hashem had perfectly calibrated the nisayon and delivered only the precise dosage of difficulty that we were supposed to experience. Sick child — yes. Eight-day hospital stay — yes. Frenzied, last-minute Pesach preparations — yes. Emotional pain and turmoil — no.
In the midst of our crisis, I felt Hashem’s perfectly measured septic-honeysuckle love.
(Originally featured in Mishpacha, Issue 621)
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